Claims handling and return-to-work systems can leave a person worse off than the original injury did. The research finds it, the courts have punished it at record levels, and the people moving through it describe it in the same words. Every figure traces to a primary source.
In a study of injured workers, the systemic problems became a second injury in themselves. (69 interviews.)
MacEachen, Kosny, Ferrier & Chambers (2010), Journal of Occupational Rehabilitation. doi:10.1007/s10926-010-9229-5 (opens in a new tab)
In a Quebec study, stigmatization and the power imbalance between claimant and system harmed mental health. The process, not only the injury, causes harm. (85 interviews.)
Lippel (2007), International Journal of Law and Psychiatry. doi:10.1016/j.ijlp.2007.06.013 (opens in a new tab)
In a Canadian healthcare organization, managers felt unable to act on the part of the process they control. The supervisor is the live variable, given no support.
Maiwald et al. (2014), Work. doi:10.3233/wor-131727 (opens in a new tab)
This is the public court record, not an attack list. We cite these rulings as evidence of why a standard is needed, and we build with the carriers already moving to meet one. Company names appear only inside the public case citations.
An insurer denied a stroke survivor’s long-term-disability claim on the theory she could do other work, relying only on the evidence that supported denial. A jury found bad faith, and the Court of Appeal upheld the largest known LTD punitive award in Canada, describing “a closed loop of information that ignored contrary information.” Also $40,000 aggravated and $220,604 in retroactive benefits.
Baker v. Blue Cross Life Insurance Company of Canada, 2023 ONCA 842 (opens in a new tab). $1.5 million, punitive.
The Supreme Court of Canada reinstated a full punitive award against “high-handed and reprehensible” claims handling. The foundation case.
Whiten v. Pilot Insurance Co., 2002 SCC 18 (opens in a new tab). $1 million, punitive.
One insurer terminated benefits on self-selected medical evidence. Another concealed for about seven years that the claim had been approved, then pressed a low settlement on a claimant in financial distress. Both breaches were upheld on appeal; leave to appeal to the Supreme Court was refused. $500,000 against one insurer; $675,000 combined.
Branco v. American Home Assurance Company and Zurich Life Insurance Company, 2015 SKCA 71 (opens in a new tab). $500,000, punitive against one insurer.
An insurer discontinued an approved claim for 17 months on a “malingering” theory against the contrary medical evidence. The financial harm to the claimant was severe. The court punished the process itself. Plus $50,000 aggravated.
Greig v. Desjardins Financial Security Life Assurance Co., 2019 BCSC 1758 (opens in a new tab). $200,000 punitive.
After a receptionist’s benefits were discontinued following six years on claim, the Supreme Court upheld aggravated damages, because the whole purpose of the contract is security.
Fidler v. Sun Life Assurance Co. of Canada, 2006 SCC 30 (opens in a new tab). $20,000, aggravated.
The lived experience of people who have moved through disability claims, held as themes: never a named, quoted, or profiled individual. These are the patterns that recur.
Repeated paperwork, justifying the illness over and over, sudden benefit reversals, and recounting trauma on demand are described as making people sicker, with the distress attributed to the system rather than the original condition.
A near-universal sense that the person managing the file is looking for reasons to close it, rather than reasons to support recovery.
A demand for objective proof that does not exist for fluctuating illness, and a baseline of skepticism even with full clinician support.
Denials, repeated demands for more medical information, financial attrition, and being watched are described as pressure to give up or accept a low settlement.
The same records show the other finding: the workplace decides recovery. Read that, or add your name to the charter.
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